title: Myeloid sarcoma of the nasopharynx mimicking an aggressive lymphoma.
abstract: BACKGROUND
  Myeloid sarcoma (MS) is a rare extra-medullary tumour of the myeloid lineage, which can be a difficult diagnosis to make.
  
  
  METHODS
  We report the case of a 73-year-old male with a right-sided nasopharyngeal mass revealed on CT scan and MRI.
  
  
  RESULTS
  An initial cytological and histological examination suggested a high-grade lymphoma. Nevertheless, the final diagnosis was a MS with an unusual involvement of the nasopharynx that was treated with a conventional induction leukemia therapy. Eight months later, the patient had persistent thrombocytopenia and a bone marrow aspiration showed the dysplasia of a high grade myelodysplastic syndrome and cytogenetics detected t(3;21). The patient was treated with a 5-Azacitidine (Vidaza) protocol until overt progression and disease evolution.
  
  
  CONCLUSIONS
  In conclusion few cases of MS involving the nasopharynx have been reported. Its diagnosis is often difficult and should be considered especially when a high index of suspicion is present and the immunophenotype of the malignant haematological cells is not clearly in favour of a lymphoma.
authors.affiliation: Clinical Haematology Department, Institut Gustave Roussy (IGR), 114 rue Edouard Vaillant, 94805, Villejuif, France, Raphaeljack13@hotmail.com.
authors.forename: Jacques
authors.initials: J
authors.lastname: Raphael
authors.forename: Alexander
authors.initials: A
authors.lastname: Valent
authors.forename: Colette
authors.initials: C
authors.lastname: Hanna
authors.forename: Nathalie
authors.initials: N
authors.lastname: Auger
authors.forename: Odile
authors.initials: O
authors.lastname: Casiraghi
authors.forename: Vincent
authors.initials: V
authors.lastname: Ribrag
authors.forename: Stephane
authors.initials: S
authors.lastname: De Botton
authors.forename: Veronique
authors.initials: V
authors.lastname: Saada
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D006801:Humans; D016130:Immunophenotyping; D015470:Leukemia, Myeloid, Acute / Q000473:pathology; D008223:Lymphoma / Q000473:pathology*; D008297:Male; D009190:Myelodysplastic Syndromes / Q000150:complications / Q000473:pathology; D009303:Nasopharyngeal Neoplasms / Q000473:pathology*; D016609:Neoplasms, Second Primary / Q000473:pathology; D023981:Sarcoma, Myeloid / Q000473:pathology*